蒙古沙鼠脑缺血模型术后医源性Horner综合征报道

目的:探讨蒙古沙鼠脑缺血模型术后Horner综合征(HS)的发病机制。方法:40只沙鼠随机分为假手术组、手术1、2、3组。假手术组仅分离出颈总动脉,手术各组分离后同时夹闭双侧颈总动脉5 min。术后观察各组沙鼠出现HS情况;术前、术后1、4、7 d进行NDS评分;术后7 d灌注固定后对海马、下丘脑及脑干等部位进行HE染色。结果:假手术组HS发生率为11.1%,手术1、2、3组分别为37.5%、44.4%、60%;各组术前、术后1、4、7 d NDS差异无统计学意义(P>0.05);HE染色显示手术组海马区可见缺血改变,且细胞计数少于假手术组(P<0.05),下丘脑和脑干等部位HE染色未见缺血改变。结论:本实验HS的发生为颈部手术中机械性损伤所致,而非造模成功后脑缺血引起。

The Postoperative Iatrogenic Horner's Syndrome of Mongolian Gerbils after Cerebral Ischemia

Objective:To explore the pathogenesis of Horner's syndrome (HS) in Mongolian gerbils after cerebral ischemia.Methods:Forty gerbils were randomly divided into sham operation group and the groups ischemic operation 1,2,and 3 (n=10 respectively).Gerbils in the sham operation group were only treated with isolating carotid arteries,the ones in the ischemic operation group were treated with the bilateral common carotid artery occlusion surgery for 5 min.The incidence rates of HS,the NDS scores were compared at pre-and 1,4,7 days post-operation.Pathological changes in the hippocampus,hypothalamus and brain stems were observed by HE staining at 7 days post-operation.Results:The incidence rate of HS in the sham operation group was 11.1％ and37.5％,44.4％ and 60％.in the operation groups respectivelyNDS scores had no significant differences (P＞ 0.05) among the different groups at pre-and 1,4,7 days post-operation.In the operation group,HE staining showed obviously ischemic changes in hippocampus,ththe loss of cells was observed (P＜0.05).HE staining revealed no ischemic changes in the hypothalamus and brainstems in different groups.Conclusion:The results suggest that the high incidence rate of HS in the operation group was due to the mechanical damage during surgery instead of the complication of cerebral ischemia.